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UTILIZATION OF A CLINICAL LADDER PROCESS AS A STRATEGY TO FACILITATE THE ORIENTATION OF AN ADVANCED PRACTICE PROVIDER INTO A CARDIOLOGY PRACTICE
2498 JACC March 21, 2017 Volume 69, Issue 11
Spotlight on Special Topics UTILIZATION OF A CLINICAL LADDER PROCESS AS A STRATEGY TO FACILITATE THE ORIENTATION OF AN ADVANCED PRACTICE PROVIDER INTO A CARDIOLOGY PRACTICE Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Innovations in Practice Management and Social Media Abstract Category: 42. Spotlight on Special Topics: Education, Innovation, Advocacy, Social Media, Leadership and Practice Management Presentation Number: 1130-438 Authors: Charlene G. Shallow, Jennifer Black, Prairie Cardiovascular Consultants, Springfield, IL, USA
Background: Hiring the best is only half the battle. Healthcare providers as a group have a relatively low job turnover rate. Studies have demonstrated that on average the annual turnover rate for advanced practice providers (APPs) is between 11% to 13%. At Prairie Cardiovascular (PCC) the turnover was higher and in reviewing the data it suggested that the attrition rate appeared to drop off after 2 to 3 years of employment. Cost of Turnover: The Robert Wood Johnson Foundation reports that replacement healthcare costs for APPs can cost as much as 20% of annual pay. Because APP roles are so complex, their departure is often felt acutely by the remaining team. Resulting in increased demands on top of the regular workload. Other costs include decreased quality patient care and delivery, lower productivity, reduced morale and loss of historical knowledge. A decision was made to adopt a strategic focus on new hire onboarding and retention. Methods: A new APP provider usually comes with basic education and limited focus on specialty care. Exit interviews had a common theme the APPs did not feel adequately prepared and the environment was demanding and very complex. Prairie Cardiovascular initiated a clinical ladder program in the first quarter of 2011. This program provided the APP an opportunity to gradually take on more complex patients over time helping to decrease the burden on the “newbie” having to know it all as soon as their orientation was complete. Results: Implementation of a PCC clinical ladder has decreased APP turnover from an average of 30.2% (years 2003-2009 {pre-clinical ladder implementation}) to 16.7% (years 2010-2015 {post-clinical ladder implementation}). APP turnover for the past 3 calendar years (2012-2015) has averaged 10.1%• In 2015, Prairie’s APP turnover was at 9.2% (down from a 13 year high of 54.5% in 2004). Conclusions: Implementation of the clinical ladder has significantly decreased colleague turnover and helped to develop a care team model that is strong at heart.Continued efforts to improve transition to practice include implementation of an APP fellowship program to help facilitate the transition from education to clinical practice.
Spotlight on Special Topics UTILIZATION OF A CLINICAL LADDER PROCESS AS A STRATEGY TO FACILITATE THE ORIENTATION OF AN ADVANCED PRACTICE PROVIDER INTO A CARDIOLOGY PRACTICE Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Innovations in Practice Management and Social Media Abstract Category: 42. Spotlight on Special Topics: Education, Innovation, Advocacy, Social Media, Leadership and Practice Management Presentation Number: 1130-438 Authors: Charlene G. Shallow, Jennifer Black, Prairie Cardiovascular Consultants, Springfield, IL, USA
Background: Hiring the best is only half the battle. Healthcare providers as a group have a relatively low job turnover rate. Studies have demonstrated that on average the annual turnover rate for advanced practice providers (APPs) is between 11% to 13%. At Prairie Cardiovascular (PCC) the turnover was higher and in reviewing the data it suggested that the attrition rate appeared to drop off after 2 to 3 years of employment. Cost of Turnover: The Robert Wood Johnson Foundation reports that replacement healthcare costs for APPs can cost as much as 20% of annual pay. Because APP roles are so complex, their departure is often felt acutely by the remaining team. Resulting in increased demands on top of the regular workload. Other costs include decreased quality patient care and delivery, lower productivity, reduced morale and loss of historical knowledge. A decision was made to adopt a strategic focus on new hire onboarding and retention. Methods: A new APP provider usually comes with basic education and limited focus on specialty care. Exit interviews had a common theme the APPs did not feel adequately prepared and the environment was demanding and very complex. Prairie Cardiovascular initiated a clinical ladder program in the first quarter of 2011. This program provided the APP an opportunity to gradually take on more complex patients over time helping to decrease the burden on the “newbie” having to know it all as soon as their orientation was complete. Results: Implementation of a PCC clinical ladder has decreased APP turnover from an average of 30.2% (years 2003-2009 {pre-clinical ladder implementation}) to 16.7% (years 2010-2015 {post-clinical ladder implementation}). APP turnover for the past 3 calendar years (2012-2015) has averaged 10.1%• In 2015, Prairie’s APP turnover was at 9.2% (down from a 13 year high of 54.5% in 2004). Conclusions: Implementation of the clinical ladder has significantly decreased colleague turnover and helped to develop a care team model that is strong at heart.Continued efforts to improve transition to practice include implementation of an APP fellowship program to help facilitate the transition from education to clinical practice.